HIV-1 genetic diversity and resistance to antiretroviral drugs among pregnant women in Ribeirão Preto (SP), Brazil. Cross-sectional study
Keywords:
HIV-1, Pregnancy, Drug resistanceAbstract
BACKGROUND: Increasing genetic diversity of HIV-1 and emergence of drug-resistant mutations may reduce the efficacy of antiretroviral therapy and prophylaxis that are used to prevent mother-to-child transmission. The aim of this study was to assess the genetic diversity and prevalence of drug-resistant mutations among HIV-infected pregnant women. DESIGN AND SETTING: Cross-sectional study at an outpatient clinic for infectious diseases within gynecology and obstetrics. METHODS: This study evaluated the dynamics of HIV-1 subtypes and the prevalence of transmitted and acquired drug-resistant mutations among 38 HIV-infected pregnant women (20 previously exposed to anti-retroviral therapy and 18 naive), in Ribeirão Preto (SP), Brazil, between 2010 and 2011. Genotyping was performed by means of molecular sequencing of the protease and reverse transcriptase regions of the HIV-1 pol gene. RESULTS: Subtype B was identified in 84.2% of the samples, recombinant forms between B and F in 7.9%, subtype F1 in 5.3% and the recombinant form K/F in 2.6%. No mutation associated with transmitted drug resistance was detected in the samples from the naive pregnant women, whereas mutations associated with acquired drug resistance were found in 35.0% of the pregnant women previously exposed to anti-retroviral therapy. CONCLUSION: The results showed that subtype B predominated, while there was low prevalence of sequences with transmitted drug resistance.
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Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde - Departamento de DST, Aids e Hepatites Virais. Boletim epidemiológico HIV e AIDS. Ano IV — no 01. Brasília: Ministério da Saúde; 2015. Available from: http://www.aids.gov.br/pt-br/pub/2015/boletim-epidemiologicohivaids-2015 Accessed in 2017 (Oct 10).
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde - Departamento de DST T, Aids e Hepatites Virais. Boletim epidemiológico HIV e AIDS. Ano V — no 01. Brasília: Ministério da Saúde; 2016. Available from: http://www.aids.gov.br/pt-br/pub/2016/boletim-epidemiologicode-aids-2016 Accessed in 2017 (Oct 10).
Secretaria de Estado da Saúde de São Paulo. Coordenadora de Controle de Doenças. Centro de Referência e Treinamento. DST/Aids-CRT-DST/Aids-SP. Programa Estadual DST/Aids de São Paulo. Boletim Epidemiológico. CRT-PE-DST/AIDS/CVE. Secretaria de Estado da Saúde. Ano XXXII no 1. São Paulo; 2015. Available from: http://www.saude.sp.gov.br/resources/crt/vig.epidemiologica/boletim-epidemiologicocrt/boletim_2015_versao_final.pdf Accessed in 2017 (Oct 10).
Kourtis AP, Bulterys M. Mother-to-child transmission of HIV: pathogenesis, mechanism and pathways. Clin Perinatol. 2010;37(4):721-37. PMID: 21078446.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis, do HIV/Aids e das Hepatites Virais. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos. Brasília: Ministério da Saúde; 2017.) Available from: http://www.aids.gov.br/pt-br/pub/2013/protocolo-clinico-e-diretrizes-terapeuticas-para-manejo-da-infeccao-pelo-hiv-em-adultos Accessed in 2017 (Nov 6).
Teixeira PR, Vitória MA, Barcarolo J. Antiretroviral treatment in resource-poor settings: the Brazilian experience. AIDS. 2004;18 Suppl. 3:S5-7. PMID: 15322477.
Marins JR, Jamal LF, Chen SY, et al. Dramatic improvement in survival among adult Brazilian AIDS patient. AIDS. 2003;17(11):1675-82. PMID: 12853750.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de DST T, Aids e Hepatites Virais. Transmissão vertical de HIV e sífilis: estratégias para redução e eliminação. Brasília: Ministério da Saúde; 2014. Available from: https://prevencaodstaidshvtb.files.wordpress.com/2014/12/folder_transmissao_vertical_hiv_sifilis_web_pd_60085.pdf Accessed in 2017 (Oct 3).
Marcelin AG, Delaugerre C, Wirden M, et al. Thymidine analogue reverse transcriptase inhibitors resistance mutations profiles and association to other nucleoside reverse transcriptase inhibitors resistance mutations observed in the context of virological failure. J Med Virol. 2004;72(1):162-5. PMID: 14635026.
Brindeiro RM, Diaz RS, Sabino EC, et al. Brazilian Network for HIV Drug Resistance Surveillance (HIV-BResNet): a survey of chronically infected individuals. AIDS. 2003;17(7):1063-9. PMID: 12700457.
Inocencio LA, Pereira AA, Sucupira MC, et al. Brazilian Network for HIV Drug Resistance Surveillance: a survey of individuals recently diagnosed with HIV. J Int AIDS Soc. 2009;12:20. PMID: 19765271.
Carvalho BC, Cardoso LP, Damasceno S, Stefani MM. Moderate prevalence of transmitted drug resistance and interiorization of HIV type 1 subtype C in the inland North State of Tocantins, Brazil. AIDS Res Hum Retroviruses. 2011;27(10):1081-7. PMID: 21417758.
Sanabani SS, Pastena ÉR, da Costa AC, et al. Characterization of partial and near full-length genomes of HIV-1 strains sampled from recently infected individuals in São Paulo, Brazil. PLoS One. 2011;6(10):e25869. PMID: 22022460.
Santos LA, Monteiro-Cunha JP, Araujo AF, et al. Detection of distinct human immunodeficiency virus type 1 circulating recombinant forms in northeast Brazil. J Med Virol. 2011;83(12):2066-72. PMID: 22012712.
Cunha LK, Kashima S, Amarante MF, et al. Distribution of human immunodeficiency virus type 1 subtypes in the State of Amazonas, Brazil, and subtype C identification. Braz J Med Biol Res. 2012;45(2):104-12. PMID: 22249428.
Gaspareto KV, Mello FMMA, Dias JRC, et al. Diversidade genética e resistência primária entre pacientes HIV-1-positivos de Maringá, Paraná, Brasil [Genetic diversity and primary resistance among HIV-1-positive patients from Maringá, Paraná, Brazil]. Rev Inst Med Trop S Paulo. 2012;54(4):207-13. doi: 10.1590/S0036-46652012000400005.
Corado AL, Bello G, Leão RA, Granja F, Naveca FG. HIV-1 genetic diversity and antiretroviral drug resistance among individuals from Roraima state, northern Brazil. PLoS One. 2017;12(3):e0173894. PMID: 28301548.
Delatorre E, Silva-de-Jesus C, Couto-Fernandez JC, Pilotto JH, Morgado MG. High HIV-1 Diversity and Prevalence of Transmitted Drug Resistance Among Antiretroviral-Naive HIV-Infected Pregnant Women from Rio de Janeiro, Brazil. AIDS Res Hum Retroviruses. 2017;33(1):68-73. PMID: 27392995.
Duani H, Aleixo AW, Tupinambás U. Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012. Braz J Infect Dis. 2017;21(2):148-54. PMID: 28017554.
Machado LF, Costa IB, Folha MN, et al. Lower genetic variability of HIV-1 and antiretroviral drug resistance in pregnant women from the state of Pará, Brazil. BMC Infect Dis. 2017;17(1):270. PMID: 28403828.
Librelotto CS, Gräf T, Simon D, Almeida SEM, Lunge VR. HIV-1 epidemiology and circulating subtypes in the countryside of South Brazil. Rev Soc Bras Med Trop. 2015;48(3):249-57. PMID: 26108001.
Ferreira JL, Rodrigues R, Lança AM, et al. Transmitted Drug Resistance among People Living with HIV/Aids at Major Cities of Sao Paulo State, Brazil. Adv Virol. 2013;2013:878237. PMID: 23401688.
Santoro MM, Perno CF. HIV-1 Genetic Variability and Clinical Implications. ISRN Microbiol. 2013;2013:481314. PMID: 23844315.
de Sa-Filho DJ, Soares M da S, Candido V, et al. HIV type 1 pol gene diversity and antiretroviral drug resistance mutations in Santos, Brazil. AIDS Res Hum Retroviruses. 2008;24(3):347-53. PMID: 18327988.
de Sa-Filho DJ, Ambar RF, Duarte NB, et al. HIV type 1 diversity from newly diagnosed patients in Santos metropolitan area/Brazil. AIDS Res Hum Retroviruses. 2009;25(9):925-9. PMID: 19689200.
Lima YA, Reis MN, Cardoso LP, Stefani MM. HIV-1 infection and pregnancy in young women in Brazil: socioeconomic and drug resistance profiles in a cross-sectional study. BMJ Open. 2016;6(7):e010837. PMID: 27381205.
Ferreira AS, Cardoso LP, Stefani MM. Moderate prevalence of transmitted drug resistance and high HIV-1 genetic diversity in patients from Mato Grosso State, Central Western Brazil. J Med Virol. 2011;83(8):1301-7. PMID: 21678433.
